| Background and Objectives:Oral squamous cell carcinoma is the most common malignant tumor in the oral and maxillofacial region,which is located on the tongue,gums,lips,cheeks,jaw and other parts.At present,the treatment methods of oral squamous cell carcinoma are still surgery,supplemented by radiotherapy,chemotherapy and other comprehensive treatment,although patients in tissue preservation and overall quality of life benefit,but due to trauma,high recurrence rate,high transfer rate and has a bad prognosis.Therefore,more and more scholars focus on the etiology of oral squamous cell carcinoma,in order to seek more effective treatment.With the development of immunology and molecular biology,immune factors are becoming more and more concerned.The aim of this study was to investigate the pathogenesis of oral squamous cell carcinoma by using flow cytometry,to investigate the expression of immune cells in peripheral blood of patients with oral squamous cell carcinoma before and after chemotherapy,and to explore the pathogenesis of oral squamous cell carcinoma.It is helpful to optimize the immunotherapy program and enhance the anti-tumor immune response and provide a reliable theoretical basis for the immunotherapy of oral squamous cell carcinoma.Materials and Methods:1.Clinical Data: 40 cases of Department of Oral and Maxillofacial Surgery of the First Affiliated Hospital of Zhengzhou University were selected in February 2015 to August 2016,which confirmed as the oral squamous cell carcinoma by pathological examination after surgery.All patients had a definite pathological diagnosis and the complete clinical data.Female: 18 cases,Male:22 cases;Aged 29~81.All the patients had not been treated with anti tumor therapy before admission,and all of them were excluded from the systemic lymphatic system.The location of the disease included the tongue,cheek,gum,and the bottom of the mouth.Another 15 cases of healthy people were selecte as a healthy control group.2.Method: Chemotherapy drugs using fluorouracil injection,once every 5 days;oxaliplatin injection,the first day.The patients in the treatment group were collected fresh peripheral blood 2 days preoperative,3 weeks postoperative,2 days before the first cycle of chemotherapy,2 weeks after the first cycle of chemotherapy,2 days before the second cycle of chemotherapy,2 weeks after the second cycle of chemotherapy.Flow cytometry was used to detect the percentage of CD3+,CD4~+,CD8~+ and CD4~+/CD8~+ in T lymphocyte subsets,the percentage of B lymphocytes(CD19+)and the percentage of NK lymphocytes(CD56+).Results:1.The percentage of CD3+,CD4~+,CD8~+,NK and B lymphocytes in peripheral blood of patients with oral squamous cell carcinoma before operation compared with the healthy control group,the expression of CD3+ and CD4~+ in peripheral blood of patients with oral squamous cell carcinoma was decreased,the expression of CD8~+ and NK increased and the CD4~+/CD8~+ ratio decreased or inverted,the difference was statistically significant(P < 0.05).2.Detection the peripheral blood cells in patients with oral squamous cell carcinoma after 3 weeks,the expression of CD3+ was still significantly lower than that of the healthy control group,although there was a small increase in comparison with preoperative data,the difference between the two groups was not statistically significant(P > 0.05).The expression of CD4~+ was also lower than that of the healthy control group(P < 0.05),but there was a significant increase compared with preoperative(P < 0.05).The expression of CD8~+ was significantly lower than preoperative(P < 0.05),and compared with healthy control group,the difference was statistically significant(P < 0.05).The expression of NK cells compared with healthy control group no significant difference(P > 0.05),but the expression of NK cells preoperative and postoperative,there was a significant change(P < 0.05),the expressions of NK cells postoperative in patients with oral squamous cell carcinoma in peripheral blood decreased than preoperative.The expression of B cells was significantly lower than that of healthy controls(P < 0.05),but the difference was not statistically significant(P > 0.05).Although the ratio of has not yet recovered to the level of the healthy control group(P < 0.05),the value of CD4~+/CD8~+ has a certain degree of recovery compared with preoperative(P <0.05).3.Three weeks postoperative,the results were the first 2 days before chemotherapy.After a cycle of chemotherapy,2 weeks to referral,extraction of peripheral blood to detect the expression of immune cells,that is,after the first cycle of chemotherapy test results.The expression of CD3+ in peripheral blood of patients with oral squamous cell carcinoma after chemotherapy was still lower than that of the healthy control group,and the change was not significant compared with that before chemotherapy(P > 0.05).The expression of CD4~+ had no significant difference compared with that before chemotherapy(P < 0.05),which was also lower than that of the healthy control group(P < 0.05).The expression of CD8~+ before chemotherapy and compared with significant difference(P < 0.05),mainly for the drop in expression after chemotherapy in patients with oral squamous cell carcinoma in peripheral blood CD8~+ than before chemotherapy,and compared with the healthy control group no significant difference(P > 0.05).The expression of NK cells was not significantly different from that before chemotherapy(P < 0.05),but was still slightly higher than that of healthy controls(P < 0.05).B cells were lower than those in healthy controls(P < 0.05)compared with those before chemotherapy with a certain improvement(P > 0.05).Although the ratio of CD4~+/CD8~+ was not recovered to the level of the healthy control group(P < 0.05),it was higher than that before chemotherapy(P > 0.05).4.The results of the first 2 weeks after the first cycle of chemotherapy were detected by the first 2 days before the second cycle of chemotherapy.And then after the end of the second cycle of chemotherapy,2 weeks of referral,extraction of peripheral blood to detect the expression of immune cells,that is,after the second cycle of chemotherapy test results.After the second cycle of chemotherapy,the expression of CD3+ in patients with oral squamous cell carcinoma of peripheral blood was slightly higher than that before chemotherapy,which was lower than that of the healthy control group(P > 0.05).The expression level of CD4~+ and B cells was significantly higher than that before chemotherapy(P < 0.05),slightly lower than that of the healthy control group(P > 0.05).The expressions of CD8~+ and NK cells after chemotherapy were decreased compared with those before chemotherapy(P < 0.05),but not to the level of the healthy control group(P > 0.05).The ratio of CD4~+/CD8~+ was higher than that before chemotherapy(P < 0.05),which was close to that of the healthy control group(P > 0.05).Conclusion:1.There is an immune suppression in patients with oral squamous cell carcinoma.2.After surgery,oxaliplatin and fluorouracil in two cycles of chemotherapy,oral squamous cell carcinoma of the immune function is still in a low state.Surgery and the nutritional support when chemotherapy can improve the immune status of patients,and relieve some of the immune function in the body,which is beneficial to the treatment of cancer patients.3.The expression of immune cells in peripheral blood can be used as a clinical indicator to evaluate the immune status of patients with oral cancer. |
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